Prognosis is based on disease status at diagnosis, treatment response and adherence, and the patient’s life expectancy. Most people who adhere, and respond well, to treatment can expect to maintain a functional level of vision for the remainder of their lives.[106]Leske MC, Heijl A, Hyman L, et al; EMGT Group. Predictors of long-term progression in the Early Manifest Glaucoma Trial. Ophthalmology. 2007 Nov;114(11):1965-72.
http://www.ncbi.nlm.nih.gov/pubmed/17628686?tool=bestpractice.com
However, primary open-angle glaucoma is slowly progressive and may remain asymptomatic for extended periods. This may result in many patients remaining undiagnosed (>90% in low- and middle-income countries, compared with about 50% in high-income countries).[1]Weinreb RN, Leung CK, Crowston JG, et al. Primary open-angle glaucoma. Nat Rev Dis Primers. 2016 Sep 22;2:16067.
http://www.ncbi.nlm.nih.gov/pubmed/27654570?tool=bestpractice.com
[13]Jayaram H, Kolko M, Friedman DS, et al. Glaucoma: now and beyond. Lancet. 2023 Nov 11;402(10414):1788-801.
http://www.ncbi.nlm.nih.gov/pubmed/37742700?tool=bestpractice.com
Compromised peripheral vision often does not become apparent until there is considerable loss of optic nerve fibers.[107]National Institute for Health and Care Excellence. Clinical knowledge summaries. Glaucoma: what is the prognosis? Feb 2023 [internet publication].
https://cks.nice.org.uk/topics/glaucoma/background-information/prognosis
If untreated, glaucoma can eventually lead to blindness.
In a retrospective population-based cohort study of US adults diagnosed with open-angle glaucoma, the probability of glaucoma-related blindness in one or both eyes over a 20-year follow-up period was 13.5%.[108]Malihi M, Moura Filho ER, Hodge DO, et al. Long-term trends in glaucoma-related blindness in Olmsted County, Minnesota. Ophthalmology. 2014 Jan;121(1):134-41.
https://www.aaojournal.org/article/S0161-6420(13)00808-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/24823760?tool=bestpractice.com
One European chart review reported 10-year cumulative incidences of open-angle glaucoma-related blindness in at least one eye or bilaterally of 26.5% and 5.5%, respectively.[109]Peters D, Bengtsson B, Heijl A. Lifetime risk of blindness in open-angle glaucoma. Am J Ophthalmol. 2013 Oct;156(4):724-30.
https://www.ajo.com/article/S0002-9394(13)00364-4/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/23932216?tool=bestpractice.com
Comparable figures at 20 years were 38.1% and 13.5%.